When Addiction and Celebrity Collide

It’s never easy to face up to a drug or alcohol problem, but for celebrities, top executives and others who have made their mark on the world, it can seem next to impossible.

How do you admit you are out of control, after all, if you’ve always called the shots?

How can you risk a possible knock to your public persona or reputation by letting your struggles be known?

How can you take time for healing, perhaps canceling performances or temporarily stepping away from the helm of a company, when so many depend on you?

Put it together and it can become fuel for denial, causing problems to be ignored, explained away or minimized rather than addressed. As a result, the addiction can become even more entrenched and tougher to overcome. In some cases, the outcome is tragedy.

The Downside of the Spotlight

The wealth, power and fame that people in high-status positions usually amass can also work against them when addiction is in the picture. It can shield them from the consequences of their substance use, for one thing. The average person who keeps missing work because of their drinking, for example, might be forced to recognize the problem and do something about it because their boss is threatening to fire them. If you are the center of your personal empire, however, no such leverage exists. Family members, agents, managers and attorneys are often beside themselves trying to help, while they watch as someone they care about acts out a slow motion ballet of self-destruction.

They are also likely to be able to afford their substance use. Musical legend Eric Clapton, now in his 29th year of recovery, writes in his memoir of spending $16,000 a week on heroin at the height of his addiction. And, of course, the famous never lack for party guests.

There’s another damaging reality for those in elite positions: They often find themselves surrounded by people who tell them what they want to hear rather than what they need to hear. And that can include the doctors who treat them, whose judgment may falter in the presence of affluence, power or notoriety.

History is full of medical professionals who have given in to their high-powered clients’ wishes against their better judgment, enabled dangerous substance use or ignored signs of trouble. Some have done so because they’ve been dazzled by the proximity to the limelight. Some are too intimidated by the patient’s stature to stand their ground. Others see themselves as benevolently helping an extraordinary talent continue to share their gifts with the world. And then there are some who simply want to ride the gravy train as far as possible.

Doctors who keep their focus on what’s best for their patient may find themselves doing a delicate dance when substance use is at issue. If they don’t push for healthy changes, the patient will suffer physically and mentally. But if they push too hard, the conscientious doctor may simply be replaced with a more compliant medical attendant.

The Realities of Addiction

The problem with addiction, of course, is that you can’t count on the person experiencing it to recognize that they are having a problem or to have the ability to make good choices on their own behalf. Continued substance abuse changes regions of the brain related to decision-making and impulse control. It also sets in motion powerful cravings and distressing withdrawal symptoms that can make the user desperate to continue with their drug of choice.

Dealing with all that isn’t easy even in the most advantageous circumstances. Add in the pressures, responsibilities and very public profiles of those at the height of their professions, and it can become exponentially more challenging. Such elites are also likely to hang on to the idea that they know best. It’s gotten them this far, after all. As a result, listening to advice or allowing themselves to be helped can be a foreign concept.

Getting that help, however, is crucial. Left to itself, addiction tends to become a vicious cycle in which more and more of the drug is needed to get the same effect. In time, the person is no longer chasing pleasure but simply trying to avoid pain. Meanwhile, all those hard-earned accomplishments may begin to crumble.

These days, a growing body of research is helping us better understand addiction — now considered a brain disease, not a moral failing — and that translates to an ever expanding variety of effective, evidence-based treatment options. Elite professionals can even find treatment programs geared to their unique challenges.

Tens of millions of people are in successful addiction recovery in the U.S., and among them are a profusion of well-known names, many of whom openly share their stories. There’s Harry Potter’s Daniel Radcliffe, whose drinking turned him into a recluse at 20 before he found his way to sobriety; actress Jamie Lee Curtis, who overcame a prescription painkiller addiction that began after cosmetic surgery; and Sir Elton John, who talks of the relief of being able to say, after struggling with substances for 16 years, “I need help.”

By speaking out, they help combat the stigma that has kept people with addictions in the shadows — especially those in the spotlight. Their words also make clear that while the successful celebrity or executive may try to tell themselves that too much is at stake to risk pausing their careers to address their addiction issues, the opposite is true. There’s too much at stake not to.

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About David Sack, MD

Dr. Sack is board-certified in psychiatry, addiction psychiatry and addiction medicine. He previously served as president of College Health IPA, now the largest behavioral health group in California, and as senior vice president of community programs for Aspen Education Group, which he grew from a start-up to more than $20 million in annual revenue, and senior vice president of clinical research for Comprehensive NeuroScience, a CNS-focused site management organization, where he grew his division from $5 million to $30 million in annual revenues. Dr. Sack is currently the CEO of Elements Behavioral Health. Visit DrDavidSack.com to learn more.

The Science of Addiction

The stigma that surrounds addiction and mental health challenges can only be overcome through knowledge. By focusing on the science behind these disorders, I hope to help those who are struggling see past the misinformation and reclaim their lives and happiness.